Non-adherence to medication schedules causes $300 billion annual cost to healthcare system in the US, including 10% of hospital admissions and 23% of nursing home admissions. Globally, non-adherence claims millions of lives and poses threat of untreatable diseases (Vermeire, E., Hearnshaw, H., Van Royen, P., & Denekens, J. (2001). Patient adherence to treatment: three decades of research. A comprehensive review. Journal of Clinical Pharmacy and Therapeutics, 26(5), 331-342). For diabetes, for every $1 spent on medication, $7 is saved on other medical costs such as hospitalization. For high cholesterol, for every $1 spent, $5.10 is saved. For hypertension, for every $1 spent, $3.98 is saved (Medco Health Solutions, 2005).
Another example is tuberculosis, which results in 1.9 million lethal outcomes each year. Tuberculosis is normally curable with antibiotic medication administered over a period of 6 months. Adherence to tuberculosis medication saves lives and prevents spread of drug-resistant tuberculosis strains. However, ensuring medical adherence can be difficult in developing countries, especially in remote areas. Lack of adherence can result in death and development of drug-resistant forms of tuberculosis, which can infect other people and impede containment of the disease.
From the medication adherence perspective, three conditions must be ensured: 1) an appropriate medicine must be administered 2) at an appropriate time or time intervals 3) to a right person or persons. The medication assurance systems of the prior art can be broken down into three general categories: A) electronic pillboxes; B) software-based products; and 3) pill identification systems. The latter systems are mostly used for a specific task of drug identification for dispensing and marking.
Electronic pillboxes, or “smart” pillboxes, address the conditions 1) and 2) above, that is, taking the right medicine at the right time. By way of example, MedFolio™ pillbox, distributed online at www.medfoliopillbox.com, is an electronic pillbox serving as a medication identifier and reminder system. MedFolio pillbox connects to a personal computer. A software program running on the personal computer allows the patient or the caregiver to easily customize the device to specific medication regimens. MedFolio pillbox has a series of medication reminders, such as audio alerts and visual lighting alerts. The software program can communicate with a secure website to offer the option of receiving electronic messaging reminders.
Another example is MedReady™ cartwheel pillbox pre-loadable with pills, manufactured and distributed by MedReady, Inc., of Burlingame, Calif., USA. The MedReady cartwheel pillbox sounds an alarm, prompting the user to take pills at regular time intervals. A battery back-up is provided for preventing medication interruptions caused by power outages.
Yet another example of an electronic pillbox is MedSignals™ pillbox, manufactured by MedSignals, San Antonio, Tex., USA. The MedSignals pillbox reminds the patient, via alarms and a textual display, when and how to take the medications, monitors the time of administering the medications, and communicates the collected information to remote care managers. Furthermore, yet another example is a Medminder™ electronic pillbox, manufactured by MedMinder Inc., Needham, Mass., USA. Once set up, the Medminer pillbox provides patient reminders and remote medication adherence capabilities. The Medminder pillbox reminds the patient to take a medicine by lighting up an appropriate compartment. If a cup of the compartment is not lifted within an assigned time, the patient gets auditory prompts, as well as optional phone calls, text messages, and emails. A remotely located caregiver can assess the medication adherence information via the Internet.
An example of a software-based medication assurance system is a Pill Jogger™ smartphone app, developed by Pill Jogger Inc., San Francisco, Calif., USA. The Pill Jogger app reminds patients to take their pills, and keeps track of the pills taken.
A “medical substance recognition system” is disclosed by Peter Botten in US Patent Application Publication 2013/0221082 A1. The system controls pill dispensing to prevent dispensing errors. The system includes a “recognition device” based on a machine-vision digital camera, which recognizes various pills by their visual appearance. Botten also teaches that the pill recognition device can utilize “the physical, chemical, luminescent and possibly other features” of the pills.
Wade M. Poteet et al. in U.S. Pat. No. 7,154,102 B2 disclose a system and methods for detection and identification of chemical substances using UV fluorescence spectroscopy. Pharmaceuticals can be detected and identified from wavelengths of UV fluorescence spectral peaks, and concentrations of the pharmaceuticals can be evaluated from the strength of the UV fluorescence signal.
Prasant Potuluri et al. in US Patent Application Publication 2010/0045978 A1 disclose a system using a “spectral signature” of a medication for verification and identification purposes. The data processing includes correction for “response function of the spectrometer”, intensity normalization, fluorescence removal, extracting the spectral signature, and comparing the spectral signature to a database of spectral signatures of known pharmaceuticals.
Richard Garfein from University of San Diego, La Jolla, Calif., USA, has suggested to provide via Internet cell phone video recordings of patients taking tuberculosis medicine at their homes, as a proof of adherence to antibiotic treatment. This method has been termed “VCP-DOT”, or Video Cell Phone Directly Observed Therapy. However, VCP-DOT does not allow a medical professional to verify that a correct antibiotic medication was taken by the patient.
The prior art lacks a medication assurance system that would verify both the medication to be taken and the patient identity, reducing chances of incorrect medication, while providing an objective evidence of the fact of taking an appropriate medication by an appropriate person at appropriate time.